Alterations in Adipose Tissue and Hepatic Lipid Kinetics in Obese Men and Women With Nonalcoholic Fatty Liver Disease

Elisa Fabbrini, B. Selma Mohammed, Faidon Magkos, Kevin M. Korenblat, Bruce W. Patterson, Samuel Klein

Research output: Contribution to journalArticlepeer-review

375 Scopus citations

Abstract

Background & Aims: Steatosis in patients with nonalcoholic fatty liver disease (NAFLD) is due to an imbalance between intrahepatic triglyceride (IHTG) production and export. The purpose of this study was to evaluate TG metabolism in adipose tissue and liver in NAFLD. Methods: Fatty acid, VLDL-TG, and VLDL-apolipoprotein B-100 (apoB100) kinetics were assessed by using stable isotope tracers in 14 nondiabetic obese subjects with NAFLD (IHTG, 22.7% ± 2.0%) and 14 nondiabetic obese subjects with normal IHTG content (IHTG, 3.4% ± 0.4%), matched on age, sex, body mass index, and percent body fat. Results: Compared with the normal IHTG group, the NAFLD group had greater rates of palmitate release from adipose tissue into plasma (85.4 ± 6.6 and 114.1 ± 8.1 μmol/min, respectively; P = .01) and VLDL-TG secretion (11.4 ± 1.1 and 24.3 ± 3.1 μmol/min, respectively; P = .001); VLDL-apoB100 secretion rates were not different between groups. The increase in VLDL-TG secretion was primarily due to an increased contribution from "nonsystemic" fatty acids, presumably derived from lipolysis of intrahepatic and intra-abdominal fat and de novo lipogenesis. VLDL-TG secretion rate increased linearly with increasing IHTG content in subjects with normal IHTG but reached a plateau when IHTG content was ≥10% (r = 0.618, P < .001). Conclusions: Obese persons with NAFLD have marked alterations in both adipose tissue (increased lipolytic rates) and hepatic (increased VLDL-TG secretion) TG metabolism. Fatty acids derived from nonsystemic sources are responsible for the increase in VLDL-TG secretion. However, the increase in hepatic TG export is not adequate to normalize IHTG content.

Original languageEnglish
Pages (from-to)424-431
Number of pages8
JournalGastroenterology
Volume134
Issue number2
DOIs
StatePublished - Feb 2008

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